期刊
DIABETES CARE
卷 35, 期 3, 页码 565-573出版社
AMER DIABETES ASSOC
DOI: 10.2337/dc11-1795
关键词
-
资金
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) [R01-DK-76092, R01-DK-79003]
- National Institutes of Health
- National Institutes of Health Office of Dietary Supplements [UL1RR025752]
- National Center for Research Resources
- U.S. Department of Agriculture [58-1950-9001]
- Endocrine Fellows Foundation
- NIDDK [UO1-DK-48489]
- Indian Health Service
- National Institute of Child Health and Human Development
- National Institute on Aging
- National Eye Institute
- National Heart, Lung, and Blood Institute
- Office of Research on Women's Health
- National Center for Minority Health and Human Disease
- Centers for Disease Control and Prevention
- American Diabetes Association
OBJECTIVE-To investigate the association between vitamin D status, assessed by plasma 25-hydroxyvitamin D, and risk of incident diabetes. RESEARCH DESIGN AND METHODS-Prospective observational study with a mean follow-up of 2.7 years in the Diabetes Prevention Program (DPP), a multicenter trial comparing different strategies for prevention of diabetes in patients with prediabetes. We assessed the association between plasma 25-hydroxyvitamin D, measured repeatedly during follow-up, and incident diabetes in the combined placebo (n = 1,022) and intensive lifestyle (n = 1,017) randomized arms of the DPP. Variables measured at multiple study time points (25-hydroxyvitamin D, BMI, and physical activity) entered the analyses as time-varying lagged covariates, as the mean of the previous and current visits at which diabetes status was assessed. RESULTS-After multivariate adjustment, including for the DPP intervention, participants in the highest tertile of 25-hydroxyvitamin D (median concentration, 30.1 ng/mL) had a hazard ratio of 0.72 (95% CI 0.56-0.90) for developing diabetes compared with participants in the lowest tertile (median concentration, 12.8 ng/mL). The association was in the same direction in placebo (0.70; 0.52-0.94) versus lifestyle arm (0.80; 0.54-1.17). CONCLUSIONS-Higher plasma 25-hydroxyvitamin D, assessed repeatedly, was associated with lower risk of incident diabetes in high-risk patients, after adjusting for lifestyle interventions (dietary changes, increased physical activity, and weight loss) known to decrease diabetes risk. Because of the observational nature of the study, the potential association between vitamin D and diabetes needs to be confirmed in intervention studies.
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